Dr. Volpintesta reinforces the contention that the practice of internal medicine has become essentially the same as that of family practice in many, but certainly not all, groups. The plea for a single primary care specialty has been suggested by others, with the appropriate role for general internists that of consultative physician-scientists (1). However, the argument that general internists are not always differentiated in their ability to manage complex medical problems is no reason that such a differentiation is not desirable. Both disciplines need to better define their practice responsibilities when they work as a group. I agree that many patients do not understand a difference in training or competencies between an internist and family physician. The designation of an internist has always been ambiguous in its meaning, and the term adult specialist has recently been suggested as a substitute (2).